Current status and challenges of neurosurgical procedures for patients with myelomeningocele in real-world Japan
Current status and challenges of neurosurgical procedures for patients with myelomeningocele in real-world Japan
复制标题
日本现实世界中脊髓脊膜膨出患者神经外科手术的现状和挑战
DOI：
10.1007/s00381-022-05613-5
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Asai A.
中科院分区：
文献类型：
--
作者：
Nonaka M;Komori Y;Isozaki H;Ueno K;Kamei T;Takeda J;Nonaka Y;Yabe I;Zaitsu M;Nakashima K;Asai A.
BackgroundLittle is known about the real-world status of neurosurgical treatment of myelomeningocele patients. Objectives investigate the real-world status of neurosurgical treatment of myelomeningocele patients，medical claims data provided by the Japan Medical Data Center（JMDC）.MethodsThe health claims data of 556 patients with myelomeningocele from January 2005 to March 2020 were examined.神经外科手术，包括脊髓脊膜膨出修复，脊髓栓系释放，脑脊液（CSF）分流，脑脊液引流，和内窥镜第三脑室造口术（ETV）的数量determined.ResultsA共313神经外科手术进行了135例患者在74个机构在研究期间。分流存活率受患者小于1岁时翻修分流术的影响最大，其存活率显著低于患者小于1岁时进行的所有初始分流术; 1年分流存活率为35 vs 64%（P= 0.0102）。分流前接受脑脊液引流的1岁以下患者的生存率显著低于分流前未接受脑脊液引流的1岁以下患者; 1年分流存活率分别为27%和59%（P= 0.0196），81%的患者在10年后仍然没有脊髓栓系松解。在真实的世界中，对脊髓脊膜膨出相关脑积水进行脑脊液分流术时，1年内翻修分流术和分流术前脑脊液引流是降低分流术存活率的因素。
BackgroundLittle is known about the real-world status of neurosurgical treatment of myelomeningocele patients.ObjectiveTo investigate the real-world status of neurosurgical treatment of myelomeningocele patients, medical claims data provided by the Japan Medical Data Center (JMDC) were analyzed.MethodsThe health claims data of 556 patients with myelomeningoceles from January 2005 to March 2020 were examined. The number of neurosurgical procedures, including myelomeningocele repair, tethered cord release, cerebrospinal fluid (CSF) shunt, CSF drainage, and endoscopic third ventriculostomy (ETV), was determined.ResultsA total of 313 neurosurgical procedures were performed for 135 patients in 74 institutions during the study period. The shunt survival rate was most affected by shunts that were revised when the patient was less than 1 year old, which had a significantly lower survival rate than all of the initial shunts performed when the patient was less than on1 year old; the 1-year shunt survival rate was 35 vs 64% (P= 0.0102). The survival rate was significantly lower in patients younger than 1 year who had CSF drainage before shunting compared to those younger than 1 year who did not have CSF drainage before shunting; the 1-year shunt survival rate was 27 vs 59% (P= 0.0196), and 81% of patients remained free of tethered cord release 10 years later.ConclusionsIn this study, a revised shunt of less than 1 year of age and CSF drainage before shunting were the factors that lowered the shunt survival rate in the real world for CSF shunts for hydrocephalus associated with myelomeningocele.
登录
查看更多内容
影响因子：
1.9
作者：
Riva-Cambrin, Jay;Kestle, John R. W.;Simon, Tamara D.
通讯作者：
Simon, Tamara D.
脊髓脊膜膨出脑积水治疗的长期结果
DOI：
--
发表时间：
2003
期刊：
Child's Nervous System
影响因子：
--
作者：
S. Tuli;J. Drake;M. Lamberti
通讯作者：
M. Lamberti
脊髓脊膜膨出患者一生中进行的手术次数。
DOI：
--
发表时间：
2022
期刊：
Journal of Neurosurgery: Pediatrics
影响因子：
--
作者：
M. Nonaka;Haruna Isozaki;Yumiko Komori;T. Kamei;J. Takeda;Yuichiro Nonaka;I. Yabe;M. Zaitsu;Kenji Nakashima;A. Asai
通讯作者：
A. Asai
影响因子：
4.1
作者：
Spoor, Jochem K. H.;Gadjradj, Pravesh S.;de Jong, Tjeerd H. R.
通讯作者：
de Jong, Tjeerd H. R.
影响因子：
4.1
作者：
Dupepe EB;Hopson B;Johnston JM;Rozzelle CJ;Jerry Oakes W;Blount JP;Rocque BG
通讯作者：
Rocque BG